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Comparison of two protective lung ventilatory regimes on oxygenation during one-lung ventilation: a randomized controlled trial

BACKGROUND: The efficacy of protective ventilation in acute lung injury has validated its use in the operating room for patients undergoing thoracic surgery with one-lung ventilation (OLV). The purpose of this study was to investigate the effects of two different modes of ventilation using low tidal...

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Autores principales: Montes, Félix R, Pardo, Daniel F, Charrís, Hernán, Tellez, Luis J, Garzón, Juan C, Osorio, Camilo
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2987929/
https://www.ncbi.nlm.nih.gov/pubmed/21044330
http://dx.doi.org/10.1186/1749-8090-5-99
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author Montes, Félix R
Pardo, Daniel F
Charrís, Hernán
Tellez, Luis J
Garzón, Juan C
Osorio, Camilo
author_facet Montes, Félix R
Pardo, Daniel F
Charrís, Hernán
Tellez, Luis J
Garzón, Juan C
Osorio, Camilo
author_sort Montes, Félix R
collection PubMed
description BACKGROUND: The efficacy of protective ventilation in acute lung injury has validated its use in the operating room for patients undergoing thoracic surgery with one-lung ventilation (OLV). The purpose of this study was to investigate the effects of two different modes of ventilation using low tidal volumes: pressure controlled ventilation (PCV) vs. volume controlled ventilation (VCV) on oxygenation and airway pressures during OLV. METHODS: We studied 41 patients scheduled for thoracoscopy surgery. After initial two-lung ventilation with VCV patients were randomly assigned to one of two groups. In one group OLV was started with VCV (tidal volume 6 mL/kg, PEEP 5) and after 30 minutes ventilation was switched to PCV (inspiratory pressure to provide a tidal volume of 6 mL/kg, PEEP 5) for the same time period. In the second group, ventilation modes were performed in reverse order. Airway pressures and blood gases were obtained at the end of each ventilatory mode. RESULTS: PaO(2), PaCO(2 )and alveolar-arterial oxygen difference did not differ between PCV and VCV. Peak airway pressure was significantly lower in PCV compared with VCV (19.9 ± 3.8 cmH(2)O vs 23.1 ± 4.3 cmH(2)O; p < 0.001) without any significant differences in mean and plateau pressures. CONCLUSIONS: In patients with good preoperative pulmonary function undergoing thoracoscopy surgery, the use of a protective lung ventilation strategy with VCV or PCV does not affect the oxygenation. PCV was associated with lower peak airway pressures.
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spelling pubmed-29879292010-11-19 Comparison of two protective lung ventilatory regimes on oxygenation during one-lung ventilation: a randomized controlled trial Montes, Félix R Pardo, Daniel F Charrís, Hernán Tellez, Luis J Garzón, Juan C Osorio, Camilo J Cardiothorac Surg Research Article BACKGROUND: The efficacy of protective ventilation in acute lung injury has validated its use in the operating room for patients undergoing thoracic surgery with one-lung ventilation (OLV). The purpose of this study was to investigate the effects of two different modes of ventilation using low tidal volumes: pressure controlled ventilation (PCV) vs. volume controlled ventilation (VCV) on oxygenation and airway pressures during OLV. METHODS: We studied 41 patients scheduled for thoracoscopy surgery. After initial two-lung ventilation with VCV patients were randomly assigned to one of two groups. In one group OLV was started with VCV (tidal volume 6 mL/kg, PEEP 5) and after 30 minutes ventilation was switched to PCV (inspiratory pressure to provide a tidal volume of 6 mL/kg, PEEP 5) for the same time period. In the second group, ventilation modes were performed in reverse order. Airway pressures and blood gases were obtained at the end of each ventilatory mode. RESULTS: PaO(2), PaCO(2 )and alveolar-arterial oxygen difference did not differ between PCV and VCV. Peak airway pressure was significantly lower in PCV compared with VCV (19.9 ± 3.8 cmH(2)O vs 23.1 ± 4.3 cmH(2)O; p < 0.001) without any significant differences in mean and plateau pressures. CONCLUSIONS: In patients with good preoperative pulmonary function undergoing thoracoscopy surgery, the use of a protective lung ventilation strategy with VCV or PCV does not affect the oxygenation. PCV was associated with lower peak airway pressures. BioMed Central 2010-11-02 /pmc/articles/PMC2987929/ /pubmed/21044330 http://dx.doi.org/10.1186/1749-8090-5-99 Text en Copyright ©2010 Montes et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Montes, Félix R
Pardo, Daniel F
Charrís, Hernán
Tellez, Luis J
Garzón, Juan C
Osorio, Camilo
Comparison of two protective lung ventilatory regimes on oxygenation during one-lung ventilation: a randomized controlled trial
title Comparison of two protective lung ventilatory regimes on oxygenation during one-lung ventilation: a randomized controlled trial
title_full Comparison of two protective lung ventilatory regimes on oxygenation during one-lung ventilation: a randomized controlled trial
title_fullStr Comparison of two protective lung ventilatory regimes on oxygenation during one-lung ventilation: a randomized controlled trial
title_full_unstemmed Comparison of two protective lung ventilatory regimes on oxygenation during one-lung ventilation: a randomized controlled trial
title_short Comparison of two protective lung ventilatory regimes on oxygenation during one-lung ventilation: a randomized controlled trial
title_sort comparison of two protective lung ventilatory regimes on oxygenation during one-lung ventilation: a randomized controlled trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2987929/
https://www.ncbi.nlm.nih.gov/pubmed/21044330
http://dx.doi.org/10.1186/1749-8090-5-99
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